| Background: Gastric carcinoma is one of the malignant tumors threatening thehealth of people, and the prevalence is very high in many countries. Gastric carcinomais fourth among the most common malignant tumors in the world. In Japan, it is themost common malignant tumors in men, but in North America, it is rare. The regionalvariation is significant in diseased parts of gastric carcinoma not in cardia department,and the prevalence of this sort of gastric carcinoma is higher in Japan, Korea, China,Taiwan, Peru, Costa Rica, et al. In China, gastric carcinoma is one of the most commoncaner. Statistics have shown that the prevalence is second in men of China amongmalignant tumors, only second to lung caner. The treatment of gastric carcinoma isbased on operation, and the5year survival rate is less than50%. In general, the survivalrate of gastric carcinoma postoperative is20%-30%. Hence, postoperative adjuvantchemotherapy is very important. The adjuvant chemotherapy by platinum and paclitaxelis concerned more and more. But the efficacy of chemotherapy is restricted by the drugresistance of chemotherapeutic drugs. Hence, we study the mechanism of drugresistance, aimed to provide basis to the choice of chemotherapeutic drugs in gastriccarcinoma chemotherapy. ERCC1is the important factor in nucleotide excision repairpathway. The pathway is a significant mechanism of cisplatin resistance, and play animportant role in cisplatin resistance, which is concerned in recent years, andresearchers has made great progress. β-tubulin Ⅲ is the main component of microtubulestructure, and microtubule is the important part of cytoskeleton. Microtubule isimportant in mitotic, and microtubule is the target part of taxane drug. Microtubule isconcerned in recent years. The purpose of the study is to explore the expression ofERCC1and β-tubulinⅢ, at the same time, explore the expression of ERCC1andβ-tubulinⅢ in tumor tissue of patients who received chemotherapy containing platinumand taxane after radical gastrectomy, and the correlation between ERCC1, β-tubulinⅢand clinical pathological features, and the affect to the survival time of patients whoreceived chemotherapy containing platinum and taxane. To guide the individualized treatment of gastric carcinoma.Objectives: To exam the expression of ERCC1and β-tubulinⅢ in different gastriccarcinoma tissue using immunohistochemical methods. Analyze the correlation betweenthe expression of ERCC1/β-tubulinⅢ and the clinical features of gastriccancer/survival. Explore the affect the expression of ERCC1and β-tubulinⅢ to thesurvival time of patients who received chemotherapy containing platinum and taxane.To guide the individualized treatment of gastric carcinoma.Methods: Study the clinical date and pathological block of34patients from Dalianmedical university who received gastric carcinoma radical operation from2006.1.1to2011.10.1, and22cases received platinum-based adjuvant chemotherapy postoperative,and23cases received taxol-based adjuvant chemotherapy postoperative. To exam theexpression of ERCC1and β-tubulinⅢ in gastric carcinoma tissue throughimmunohistochemical method. Chi-squared test have used to analyze the correlationbetween the expression of ERCC1and β-tubulinⅢ and the clinicopathological featuresof gastric carcinoma. Kaplan-Meier method has been used to analyze the affect of theexpression of ERCC1and β-tubulinⅢ to the survival of gastric carcinoma who receivedchemotherapy containing platinum and taxane. Using SPSS18.0software for statisticalanalysis.Results:1. Among the34cases of gastric caner, ERCC1-positive expression was16cases,positive expression rate was47.0%; β-tubulinⅢ-positive expression was15cases,positive expression rate was44.1%. There were no significant differences for theexpression of ERCC1and β-tubulinⅢ in the three tissue types of stomach differentiatedadenocarcinoma, poorly differentiated adenocarcinoma and signet cell carcinoma（P=0.923, P=0.972).2. There was no correction between the expression of ERCC1/β-tubulinⅢ andGender/age/diseased parts/tumor size/depth of invasion/histological type/lymphnode metastasis/distant metastasis/TNM stage.3. The disease-free survival of ERCC1-positive expression patients was11months,and the disease-free survival of ERCC1-negative expression patients was14.5months,p=0.074. No difference were observed. The median survival time of ERCC1-positiveexpression patients was20months. The median survival time of ERCC1-negativeexpression patients was23.5months, p=0.012, statistically significant.4. The disease-free survival of β-tubulinⅢ-positive expression patients was10 months, and the disease-free survival of β-tubulinⅢ-negative expression patients was15months, p=0.004, statistically significant. The median survival time ofβ-tubulinⅢ-positive expression patients was10months. The median survival time ofβ-tubulinⅢ-negative expression patients was21months, p=0.03, statistically significant5. The overall survival of patients with ERCC1-positive expression andERCC1-negative expression who received adjuvant chemotherapy with platinumrespectively was20months and25months, p=0.012, statistically significant.6. The overall survival of patients with β-tubulinⅢ-positive expression andβ-tubulinⅢ-negative expression who received adjuvant chemotherapy with taxanerespectively was17months and23months, p=0.042, statistically significant..7. The survival time of patients co-exprssion of ERCC1and β-tubulinⅢ wasshorter than the co-negative expression.Conclusion:1. There was no correction between the expression of ERCC1, β-tubulin ⅢandGender/age/diseased parts/tumor size/depth of invasion/histological type/lymph nodemetastasis/distant metastasis/TNM stage.2. The patients with co-negative expression of ERCC1and β-tubulin Ⅲ hadlongersurvive time than the co-positive expression.3. The expression of ERCC1and β-tubulinⅢ may be the index of whether receivedadjuvant chemotherapy containing platinum and taxane after radical mastectomy ofgastric cancer.4. The survival time of patients with ERCC1and β-tubulin Ⅲ co-expression ofpositive was shorter than the co-expression of negative ones. |
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